Caregiver report of the experiences of infant and child diaper insecurity, social support, and utilization of resources to help meet basic family need in the United States: A nationally-representative cross-sectional survey.

Abstract

BackgroundDiaper insecurity is associated with caregiver health and quality of life through relationships with financial stress, inability to meet other basic health and material needs, constraints on engagement in community, workforce, school, and early childhood education, and negative associations with caregivers' own and their child's health and mental health.ObjectiveThe purpose of this study is to better understand affective components of diaper affordability, how these components may contribute to perceptions of social support, and to understand if and how households would like to receive diaper support.DesignCross-sectional observational study.MethodsData were collected via an online survey from March-April 2024. Surveys were completed by U.S. adults (N=1,000) who were caregivers of a child in their home wearing diapers.ResultsHalf of households (46.7%, n=467) reported diaper insecurity. Caregivers with diaper insecurity were more likely to report feeling alone (OR=8.19, CI=5.78-11.59), judged (OR=6.83, CI=5.07-9.21), helpless (OR=4.62, CI=3.54-6.03), and stressed or anxious (OR=4.54, CI=3.46-5.95) due to diaper affordability compared to those who reported being diaper secure. Most households with diaper insecurity (84.6%, n=395) had accessed resources for help meeting basic needs. Participants with diaper insecurity were less likely to feel treated in the way they deserve by healthcare professionals, community organizations, or the people close to them compared to participants without diaper insecurity. Diaper insecurity and negative affective components of diaper affordability significantly predicted perceived social support F (26, 972)=20.429, p< 0.01), adj. R²=.34. Overall, the majority of all caregivers (68.1%, n=639) reported that receiving help with diapers from a local diaper bank would be "extremely helpful" or "very helpful.".ConclusionMore families in the United States may be struggling to afford diapers than are identified with diaper insecurity screening questions. Caregivers identified negative affective components of diaper affordability including feelings of judgement and aloneness which were associated with lower perceptions of social support. Households with and without diaper insecurity indicated that receiving 50 free diapers per month per child from a local diaper bank would be helpful. The support and expansion of diaper banks' distribution efforts would help families with young children in ways they identified as meaningful.